Abstract

Background: Gastric cancer (GC) is among the top five diagnosed cancers in US Hispanics, while it's not a common cancer in Non-Hispanic Whites (NHW). In Puerto Rico (PR), GC is the fifth most common cause of cancer-related death in men and the eighth most common in women. Although the incidence of GC has decreased during the last two decades in all US racial/ethnic groups, the mortality associated to GC continues to be high and disproportionately affects Hispanics. We aimed to determine and compare the overall five-year relative survival of PR Hispanics with GC during two study periods (1998-2002 and 2003-2007) and examine the geographical distribution to establish priorities for screening and health policy. Methods: Data was obtained from the PR Central Cancer Registry (PRCCR). All occurring cases with a diagnosis of primary GC, those arising primarily from the gastroesophageal junction to the pylorus, ICD-O-3 codes C16.0 to C16.9, with histological confirmation (using ICD-O-3 codes) from January 1, 1998 to December 31, 2007 were included. Five-year overall survival rates were calculated using the incidence case file database of the PRCCR and estimated using the Kaplan Meier method. Results: For the period 1998-2002 the age-adjusted incidence rate for GC was 10.0 per 100,000 (n = 1,696), while for 2003-2007 was 8.4 per 100,000 (n = 1,595). The overall five-year relative survival for GC was 22.1% and 28.2% for the periods of 1998-2002 and 2003-2007, respectively. Age-adjusted incidence rates of GC were lower in the Metropolitan (costal) Area and its surrounding municipalities while higher in the municipalities of the mountainous regions. Conclusion: GC continues to be a common cancer among Hispanics despite decrease burden among other US racial groups. Moreover, the survival rate of GC continues to be abysmal with less than 30% 5-year survival rate. There is a geographical distribution with higher GC incidence rates in the mountainous regions. Studies evaluating biologic and environmental risk factors for GC are of utmost importance to understand this cancer disparity and establish GC screening algorithms among US Hispanics.